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systems- neuro- oc > Physiology and Pathophysiology of Pain > Flashcards

Physiology and Pathophysiology of Pain Flashcards

1
Q

what is pain?

A

unpleasant sensory and emotional experience which we primarily associate with tissue damage or describe in terms of such damage or both

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2
Q

what is nociception?

A

The detection of tissue damage by specialized

transducers connected to A-delta and C fibers

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3
Q

what do nociceptors respond to?

A

thermal, chemical, mechanical noxious stimuli

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4
Q

what are the characteristics of A alpha and A beta fibres?

A

myelinated
large diameter
proprioception, light touch

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5
Q

what are the characteristics of A delta fibres?

A

lightly myelinated
medium diameter
nocioception

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6
Q

what are the characteristics of the C fibres?

A

unmyelinated
small diameter
innocouous temperature, itch
nociception

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7
Q

which fibres conduct pain?

A

A delta and C fibres

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8
Q

what is the spinothalamic tract?

A

major tract sending impulses to thalamus

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9
Q

where are the cell bodies from the spinothalamic tract located?

A

Rexed lamina 1, 2, & 5

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10
Q

what are the different types of spinothalamic tracts?

A

Lateral and ventral or neo and paleo STT

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11
Q

where does the lateral STT terminate?

A

ventroposterior thalamic nuclei

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12
Q

where does the ventroposterior thalamic nuclei primarily feed into?

A

somatosensory cortex to facilitate the spatial, temporal and intensity discrimination of painful stimuli.

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13
Q

where does the medial thalamic nuclei recieves input from?

A

ventral spinothalamic tract

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14
Q

what is the ‘second relay station’

A

thalamus

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15
Q

what are the connections of the thalamus?

A

Cortex
Limbic system
Brainstem

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16
Q

where does pain perception occur?

A

in somatosensory cortex

17
Q

what is hyperalgesia?

A

Increased perception of pain or even perception of non-noxious stimuli as noxious stimuli

18
Q

when does hyperalgesia happen?

A

whenever there is tissue injury and inflammation

19
Q

what is primary hyperalgesia?

A

is hyperalgesia at the site of injury

20
Q

what is secondary hyperalgesia?

A

hyperalgesia in the surrounding uninjured tissue

21
Q

what changes in nociceptor does allodynia cause?

A

decreased threshold for response

22
Q

what changes in nociceptor does hyperalgesia cause?

A

exaggerated response to normal and supranormal stimuli

23
Q

what changes in nociceptor does spontaneous pain cause?

A

spontaneous activity in nerve fibres

24
Q

what is central sensitisation?

A

It is the response of second order neurons in the CNS to normal input both noxious & non-noxious

25
Q

what are the 3 main concepts of central sensitisation?

A

wind-up
classical
long-term potentiation

26
Q

what does the wind up involve?

A

Involves only activated synapses

Homosynaptic activity dependent progressive increase in response of the neurons

Manifests over the course of stimuli & terminates with stimuli

27
Q

what does the classical involve?

A

Involves opening up of new synapses (silent nociceptors)
Heterosynaptic activity dependent plasticity
Immediate onset with appropriate stimuli
Outlast the initial stimuli duration
Can be maintained even at low levels of ongoing stimuli

28
Q

what does the long term potentiation involve?

A

Involves mainly the activated synapses

Occurs primarily for
very intense stimuli

29
Q

what are the differences in acute and chronic pain?

A 
acute pain-
physiological
prescense of noxious stimuli
serves protective function
usually nociceptive
chronic pain-
pathologival
prescence of noxious stimuli is not necessary
does not serve any purpose
nociceptive, neuropathic or mixed
30
Q

what is nociceptive pain?

A

A sensory experience that occurs when specific peripheral sensory neurones (nociceptors) respond to noxious stimuli

31
Q

when does nociceptive pain resolve?

A

when damaged tissue heals (bone fractures, burns)

32
Q

what is neuropathic pain?

A

Pain initiated or caused by a primary lesion or dysfunction in the somato-sensory nervous system

33
Q

is neuropathic pain usually acute or chronic?

A

almost always chronic condition

34
Q

does neuropathic pain respond well to analgesics?

A

no

35
Q

what increases the transduction in pain?

A

NSAIDs
Ice
Rest
LA blocks

36
Q

what increases the transmission in pain?

A 
Nerve blocks
Drugs
    Opioids
    Anticonvulsants
Surgery
    DREZ
    Cordotomy
37
Q

what improves the perception in pain?

A 
Education
Cognitive behavioural therapy
Distraction
Relaxation
Graded motor imagery
Mirror box therapy
38
Q

what improves the descending modulation?

A 
Placebos
Drugs
    Opioids
    Antidepressants
Surgery
    Spinal cord stimulation

systems- neuro- oc (51 decks)

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